• Distinguishing from hernias
• Can pinch off and feel cord structures above
• Transilluminate more than hernias
• Types
• With patent processus vaginalis
• Increasing volumes of fluid can get trapped
• Potential for hernia formation too
• Without PPV
• Usually resolve without intervention within 18 months
• Consequences
• None really 
• cf Varicocele (raised temp causes infertility)
  
• Watchful waiting generally fine
• Frequency
• 30 % at birth

Inguinal hernias

• Distinguishing
• Can't get above it
• Easier to reduce
• Frequency
• 4% at birth
• Risk of incarceration
• 50% at 6 months
• 7% at 1 year

• Develops over the first month of life
• Tends to present at 5-6 weeks
• Treat by making an incision in the mucosa, allowing the muscular tissue of the sphincter to expand outwards

Undescended testes

• Frequency
• 3% at birth
• Outcome
• 65% fix themselves within 6 months
• Wait 6 months, then operate
• Risks
• 90% also have PPV
• => May present with hernia
• 1% risk of testicular cancer if not fixed by puberty
• NB testes can re-ascend during rapid pubertal growth

Testicular torsion

• Occurrence
• Neonates
• Adolescents
• Presentation
• Excruciating pain over whole testicle
• Ascending pain
• Inguinal / iliac fossa
• Careful to distinguish from appendicitis!

Umbilical hernia

• 30% of neonates
• Almost never obstruct
• => Watchful waiting

Idiopathic scrotal oedema

• Usually bilateral
• cf torsion, (epididymo)-orchitis
  
• Raw red skin over and around testicle
• But testes are not tender underneath
• Resolves in 2-3 days without intervention

Balanitis

• Inflammation of the glans of the penis
• Distinguish from just the tip
• Washing
• Irritation
• cf Balanitis xerotica obliterans

Duodenal atresia

• "Double-bubble" sign on X-ray
• Stomach + proximal duodenum
• Bile-stained vomit
• Extremely serious
• Transfer immediately to tertiary pediatric surgery centre
  

• Hirschsprung's disease
• Caused by the failure of the neural crest cells to migrate completely
• Intestine doesn't relax => Blockage
  
• Meconium ileus
• In cystic fibrosis
  

• Vitello-intestinal duct or omphalo-mesenteric duct connects the midgut to the yolk sac during early embryonic life
• It gets obliterated and disappears during fifth to sixth week of intrauterine life.If the remnants persists then following abnormalities can occur:
• Umbilical Polyp
• Umbilical Sinus
• Fibrous remnant of vitello-intestinal duct
• Meckel's Diverticulum
• Patent Vitello-intestinal duct